Treatment Of Helicobacter Pylori In Children By Different First-line Therapy

Objective:To observe the effect of different first-line therapy on Helicobacter pylori infection in children in liaoning province,and to explore the more optimized Hp eradication program.Methods:124 patients with Hp-infected upper gastrointestinal symptoms including abdominal pain were randomly divided into 4 groups.Group A: standard triple therapy(amoxicillin: 50 mg/kg/d,bid;clarithromycin: 15 mg/kg/d : Omeprazole 0.8mg/kg/d,bid)Oral treatment for 10 days;Group B: standard triple therapy(amoxicillin: 50mg/kg/d,bid;clarithromycin: 15mg/kg/d,Bid;Omeprazole 0.8mg/kg/d,bid),Oral treatment for 14 days;Group C: Triple therapy with antibacterial agent(amoxicillin: 50mg/kg/d,bid;Metronidazole: 20mg/kg/ d,bid;tincture 6-8mg/kg/d,bid),oral treatment for 14 days;Group D: sequential therapy(omeprazole 0.8mg/kg/d,bid,oral treatment for 10 days;first 5 days Amoxicillin: 50 mg/kg/d,bid;5 days after clarithromycin: 15 mg/kg/d,bid;metronidazole: 20 mg/kg/d,bid).Clinical data were recorded during the experiment: including the patient’s gender,age,clinic number,area of residence,symptoms,family history,side effects of medication,and gastroscopy.All children were followed up for 4 weeks before reexamination of the C13 urea breath test.Four groups of Hp eradication rates were compared,and gastrointestinal symptom scores were scored for all patients when they entered the group and 4 weeks after discontinuation.Whether the symptoms of the four groups were improved before and after treatment and the incidence of adverse reactions in each group were compared.Results:1.In terms of eradication rates,the standard triple triple 10-day group(group A)eradication rate was 56.7%(17/30),the standard triple-group 14-day group(group B)eradication rate was 51.6%(16/31),and the triple therapy group containing tinctures(group C)eradication rate was 68.9%(20/29),and the sequential therapy group(group D)eradication rate was 86.7%(26/30).There was no significant difference between the three groups of ABC,and there was significant statistical difference between group D and the other three groups,P<0.05;2.The total score of gastrointestinal symptoms before treatment in the 10-day group of standard triple therapy was 14.00±3.83 points,and the total product of gastrointestinal symptoms was 4.70±1.09 points after 4 weeks the end of treatment discontinuation.The total score of gastrointestinal symptoms before and after treatment was statistically significant difference(P<0.01);The total score of gastrointestinal symptoms before treatment in the standard triple therapy group for 14 days was 13.83±2.99 points,and the total score of gastrointestinal symptoms after treatment was stopped for 4 weeks was 7.33±0.99 points.There was a statistically significant difference in total scores of symptoms(P<0.01);The total score of gastrointestinal symptoms before treatment in the triple therapy group was 12.83±3.27 points,and the total score of gastrointestinal symptoms was 6.97±1.07 points after 4 weeks of treatment discontinuation.The total score of gastrointestinal symptoms before and after treatment was statistically significant(P<0.01);The total score of gastrointestinal symptoms before treatment in the sequential therapy group was 14.10±2.96 points,and gastrointestinal symptoms were stopped after 4 weeks of treatment withdrawal.The total score was 6.63±1.19 points,and the total score of gastrointestinal symptoms before and after treatment was statistically different(P<0.01).3.Before treatment,there was no significant difference in total scores of gastrointestinal symptoms between the four groups(P>0.05);after 4 weeks of discontinuation,there was no significant difference between the three groups of ABC,while there was a significant difference between group D and the other three groups(P<0.05).The total symptom scores were the lowest after the end of treatment in the sequential therapy group;the efficacy indexes of the four groups were 0.33,0.34,0.36,and 0.35,respectively,with no statistical difference(P>0.05).4.The main adverse reactions during treatment were abdominal pain,fullness,nausea and vomiting,poor appetite,etc.A group,B group,C group,D group were 6.7%(2/30),9.7%(3/31),34.5%(10/29),10.0%(3/30).There was no significant difference between the three groups in ABD,but there was a significant difference between group C and the other three groups,P<0.05..Conclusion:Different first-line treatments compared the treatment of Hp infection in children in Liaoning,the eradication rate of sequential therapy was significantly higher than other therapies,and the most significant in symptom relief.The incidence of adverse reactions,barium triple therapy is higher than sequential therapy and standard triple therapy.Therefore,sequential therapy is an ideal eradication therapy for H.pylori infection in children and is worthy of clinical application.